DOI: http://dx.doi.org/10.18203/2349-2902.isj20194102

Complications of laparoscopic cholecystectomy performed by junior surgeon in resource-restricted settings

Pon Rachel Vedamanickam

Abstract


Background: The aims of this audit were to determine the rate of complications of laparoscopic cholecystectomy performed by a junior surgeon, to identify changes that can be made to reduce the complications, and to re-audit the complication rate after the changes have been made.

Methods: Laparoscopic cholecystectomies performed by the surgeon between August and November, 2018 were assessed retrospectively. Data was collected from electronic records and operation notes and entered in the format as enclosed within. A re-audit was conducted between December 15th, 2018 and June 15th, 2019.

Results: In the initial audit, the complication rate of laparoscopic cholecystectomy was 40% and the incidence of bile leaks was 6%. The re-audit showed a significant reduction in the overall complication rate to 24% with no incidence of bile leaks.

Conclusions: The learning curve of surgeons for laparoscopic procedures is steep and cases should be chosen carefully depending on the current skill set and comfort level of the surgeon. Recommended standard practices should be followed in all situations, and all the team members should be involved in identifying risks during the surgery.


Keywords


Audit, Laparoscopic cholecystectomy, Safe techniques

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